In an 87-year-old woman with type 2 diabetes, stage 2 chronic kidney disease, hypertension, suspected rheumatoid arthritis, osteoporosis, osteoarthritis, small vessel cerebrovascular disease, and a history of a secondary generalized focal seizure requiring hospitalization, currently treated with Toujeo, aspirin, omeprazole, prednisone 2.5, denosumab, fentanyl patch 12.5, trazodone, levetiracetam, and metamizole, who presents with insomnia, nocturnal agitation (verbal outbursts, continuous complaints), and is very apathetic and barely eats during the day, with optimized non-pharmacological measures and no clinical symptoms or signs suggesting a secondary cause (fecal impaction, infection, etc.), what is the first drug to add to treat the patient's insomnia and nocturnal agitation?

Zenodo (CERN European Organization for Nuclear Research) 2026 Open access